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RESEARCH PRODUCT

Diagnoses as Selection Criteria in Drug Trials

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Drug trials are needed to establish the efficacy and safety of psychopharmacological agents in clearly defined indications. When the goal of treatment is more complex than removal of an isolated symptom (“difficulty in falling asleep” or “pain”) the syndrome or clinical entity to be treated is most easily classified by way of a diagnostic label (like “depression,” “schizophrenia,” or “panic disorder”). Dimensional models have many advantages: they often fit the data better and provide a conceptual framework for a continuum in the behavior from normal to abnormal. However, they have never reached the popularity of typological models (Strauss 1973, 1975, 1986) which reflect more the medical thinking in the form of categories (like health versus illness). Clinical practice in psychiatry also favors the use of diagnostic categories for indication and selection of patients for treatment.